For Women Facing a Breast Biopsy

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Biopsy and surgery: How they work together

For many years, an open surgical biopsy was the standard way to diagnose breast changes, including cancer. With advances in breast imaging and needle biopsy techniques, surgery is no longer the first thing done to learn more about a breast change.

First a needle biopsy, then surgery if it’s needed

There are many benefits to doing a needle biopsy first. As mentioned, most biopsies do not find cancer, so breast surgery is not needed. Needle biopsies seldom leave a scar or change the shape of the breast—surgery may do these things. Also, when breast cancer is found by a needle biopsy, a single surgery can then be planned for treatment. In most cases, when a needle biopsy is done first, there is less time from cancer diagnosis to the start of treatment. The best possible cancer treatment can be planned, the need for repeat surgery is decreased, and the cost to diagnose and treat breast cancer is greatly reduced.

In this two-step approach, the biopsy is most often done on an outpatient basis. Local anesthesia is used (the breast is numbed), so you stay awake. Many women choose local anesthesia plus a sedative (medicine to help you relax). The sedative makes you feel sleepy and calms any nervous or anxious feelings you may have during the procedure. The biopsy may take about an hour. You can go home an hour or so later, when the sedative wears off, but you will need someone to drive.

With the two-step procedure, if the diagnosis is breast cancer, you usually don’t have to decide on treatment right away. With most breast cancers, there is no harm to your health in waiting a few weeks. This gives you time to talk about your treatment options with your doctors, family, and friends, and then decide what’s best for you. (You can get more information on treatment options by calling us or visiting our Web site; see the section called “To learn more.”)

Using surgery to do the biopsy

In rare cases, a surgical biopsy may be needed to diagnose breast cancer—this is when the biopsy is done, and if cancer is found it’s removed during the same operation. This happens less than 5-10% of the time. It’s important to know all of your treatment options beforehand because you must make important choices before the procedure begins. You will not know if the breast change was cancer or what type of surgery was done until after you wake up from the surgery. When breast cancer is diagnosed with surgery, a second surgery is often still needed for final treatment.


Last Medical Review: 07/13/2012
Last Revised: 07/13/2012